烧盐(半升) 温汤(五大升)
和服探吐。
诸腹痛,连于胁膈,手足冷,脉来伏匿者,此方主之。
凡腹痛连于胁膈,多是饮食、痰饮填塞至阴,抑遏肝胆之气。肝者将军之官,胆者少阳
上升之令,抑之不得敷畅,两实相搏,令人自痛。所以痛连胁膈者,少阳之经行于两胁,厥
阴肝脉贯于膈也。手足冷者,少阳之气不敷也。脉来伏者为痛甚,阳气闭藏之象也。经曰∶
木郁则达之,故用吐法。咸能软坚,故用烧盐。
附子(二钱,炮) 人参 草豆蔻 干姜 白芍药 炙甘草 官桂(各一钱五分) 吴
茱萸 陈
客寒犯胃,胃脘当心而痛,脉来沉迟者,此方主之。
客寒犯胃,多是饮食寒冷,或因食后呼吸冷气所致。脉来沉者为里,迟者为寒。是方也,
附子、干姜、官桂、吴茱萸、草豆蔻、益智仁,辛热之品也,用之所以扶阳。邪之所凑,其
气必虚,故用人参、白术、甘草甘温之品以助胃。用芍药者,取其味酸,能泻土中之木,用
陈皮者,取其辛香,能利腹中之气。
半夏(姜汁制,五钱) 茯苓(四钱) 浓朴(三钱,姜汁炒) 紫苏(二钱)
七气相干,阴阳不得升降,攻冲作痛者,此方主之。
三因者,内因、外因、不内外因也。七气者,寒气、热气、怒气、恚气、喜气、忧气、
愁气也。以三因而郁,七气升降有妨,则攻冲而痛。是方也,紫苏之辛芳,可使散七气。浓
朴之苦温,可使下七气。半夏之辛温,茯苓之淡渗,可使平水谷相干之七气。
凡是腹痛牵连至胁部和膈部,手足发冷,脉象沉伏隐匿的,此方主治。
大凡腹痛牵连至胁膈部位,多是因为饮食停滞或痰饮积聚于至阴之处,抑制遏制了肝胆之气。肝被称为将军之官,胆主少阳上升之气机,若被抑制而不能舒展畅达,两实邪相互搏结,导致人体自感疼痛。之所以疼痛牵连胁膈,是因为少阳经脉行经两侧胁肋,厥阴肝脉贯穿膈肌。手足发冷,是因为少阳之气不能敷布周身。脉象沉伏,说明疼痛剧烈,是阳气闭藏不出的征象。《内经》说:“木郁则达之”,因此采用吐法。咸味能软坚散结,因此使用烧盐。
附子(二钱,炮制)、人参、草豆蔻、干姜、白芍药、炙甘草、官桂(各一钱五分)、吴茱萸、陈皮。
外寒客犯胃腑,多是因为进食寒冷食物,或者食后呼吸冷气所致。脉象沉主里证,迟主寒证。本方中,附子、干姜、官桂、吴茱萸、草豆蔻、益智仁均为辛热药物,使用它们是为了扶助阳气。邪气聚集的地方,正气必然虚弱,所以用人参、白术、甘草等甘温药物来辅助胃气。使用芍药,是取其酸味,能够泻除脾土中过盛的肝木之气;使用陈皮,是取其辛香之性,能够疏通腹部的气机。
半夏(用姜汁炮制,五钱)、茯苓(四钱)、浓朴(三钱,用姜汁炒)、紫苏(二钱)。
七种气机相互干扰,导致阴阳之气升降失常,攻冲作痛的,此方主治。
所谓“三因”,是指内因、外因、不内外因。所谓“七气”,是指寒气、热气、怒气、恚气(愤恨之气)、喜气、忧气、愁气。由于三因导致气机郁滞,七气升降受阻,从而发生攻冲疼痛。本方中,紫苏的辛芳之气,可以发散七气;浓朴的苦温之性,可以降下七气;半夏的辛温、茯苓的淡渗,可以平息水谷相干所致的七气。
Roasted salt (half sheng) and warm water (five large sheng) are mixed and taken to induce vomiting for exploration.
For cases of abdominal pain radiating to the hypochondrium and diaphragm, accompanied by coldness in the hands and feet, and a submerged or hidden pulse, this formula is indicated.
Generally, abdominal pain radiating to the hypochondrium and diaphragm is mostly caused by food stagnation or phlegm-fluid retention obstructing the extreme yin, thereby suppressing and inhibiting the qi of the Liver and Gallbladder. The Liver is regarded as the "General," and the Gallbladder governs the ascending function of Shaoyang (Lesser Yang). When suppressed and unable to spread smoothly, the two excess pathogens contend with each other, causing spontaneous pain. The reason the pain radiates to the hypochondrium and diaphragm is that the Shaoyang meridians traverse the bilateral hypochondrium, while the Jueyin (Greater Yin) Liver meridian passes through the diaphragm. Coldness in the hands and feet indicates that Shaoyang qi fails to distribute throughout the body. A submerged pulse signifies severe pain and is a manifestation of yang qi being concealed. As stated in the classics: "When wood is depressed, it should be dispersed"; therefore, the vomiting method is employed. Salty flavors can soften hardness; thus, roasted salt is used.
Fuzi (Aconiti Lateralis Radix Praeparata, 2 qian, processed), Renshen (Ginseng Radix et Rhizoma), Caodoukou (Amomi Fructus Rotundus), Ganjiang (Zingiberis Rhizoma), Baishao (Paeoniae Radix Alba), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparatum), Guongui (Cinnamomi Ramulus), Wuzhuyu (Evodiae Fructus), Chenpi (Citri Reticulatae Pericarpium).
For cases where external cold invades the Stomach, causing pain in the epigastrium at the heart's location, with a deep and slow pulse, this formula is indicated.
External cold invading the Stomach is mostly caused by consuming cold foods or inhaling cold air after eating. A deep pulse indicates interior conditions, and a slow pulse indicates cold. In this formula, Fuzi, Ganjiang, Guongui, Wuzhuyu, Caodoukou, and Yizhiren are acrid and hot substances; they are used to support yang qi. Where pathogenic factors gather, qi must be deficient; therefore, Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), and Gancao are used—sweet and warm substances—to assist stomach qi. Shaoyao is used for its sour flavor, which can drain the wood within the earth (Spleen); Chenpi is used for its acrid and aromatic nature, which can promote the flow of qi in the abdomen.
Banxia (Pinelliae Rhizoma, prepared with ginger juice, 5 qian), Fuling (Poria, 4 qian), Houpo (Magnoliae Officinalis Cortex, 3 qian, stir-fried with ginger juice), Zisu (Perillae Folium, 2 qian).
For cases where seven types of qi interfere with each other, leading to dysfunction in the ascending and descending of yin and yang qi, resulting in attacking pain, this formula is indicated.
The "Three Causes" refer to internal causes, external causes, and non-internal/non-external causes. The "Seven Qi" refer to cold qi, heat qi, anger qi, resentment qi, joy qi, worry qi, and sorrow/grief qi. Due to the three causes, qi becomes depressed, and the ascending and descending of the seven qi are hindered, leading to attacking pain. In this formula, the acrid and fragrant nature of Zisu can disperse the seven qi; the bitter and warm nature of Houpo can descend the seven qi; the acrid and warm nature of Banxia and the bland and draining nature of Fuling can pacify the seven qi caused by the interference between water and grain.